Provider Demographics
NPI:1700275567
Name:LOWERY, WAEEMANY NINA
Entity type:Individual
Prefix:MISS
First Name:WAEEMANY
Middle Name:NINA
Last Name:LOWERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:WAEEMANY
Other - Middle Name:NINA
Other - Last Name:SANAKEO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 BRIARVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37115-7470
Mailing Address - Country:US
Mailing Address - Phone:615-868-3131
Mailing Address - Fax:
Practice Address - Street 1:1308 BRIARVILLE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-5127
Practice Address - Country:US
Practice Address - Phone:615-868-3131
Practice Address - Fax:616-868-3192
Is Sole Proprietor?:No
Enumeration Date:2015-01-16
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19021363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily